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Regenerative medicine seeks not only to cure disease, but also to arrest the aging process itself. So far, public attention to the new health care has focused on two of its methods: embryonic stem-cell research and therapeutic cloning. Since both processes manipulate embryos, they alarm those who believe life begins at conception. Such religious objections have dominated headlines on the topic, and were central to President George W. Bush's decision to restrict stem-cell research.

Although they are now politically potent, the present religious objections to regenerative medicine will soon become irrelevant. Scientists are fast developing new ways of culturing the biological materials now exclusively produced by embryos. Given their expressed commitment to the sanctity of life, religious leaders will soon find the tables turned: researchers will accuse them of causing death if they fail to support medicine that cures the sick without harming embryos.

Perhaps anticipating this development, those uneasy with regenerative medicine have tried to shift the debate to focus on its long-term effects. They believe that innovations that now look benign might lead to an era of untrammeled biotechnological manipulation of our lives. For example, the same technology used to eliminate disease-causing genes or to clone embryos may eventually be deployed to produce genetically engineered children. That could, in turn, entrench class differences, since only the wealthy could afford the most desirable genetic enhancements.

Such objections may be speculative. Nevertheless, they deserve more attention - not necessarily as predictions of the future, but as indictments of the present. We are all disturbed by hypothetical dystopias like Huxley's Brave New World. But their most important flaws - the inequality, degradation, and moral irresponsibility of their inhabitants - are already apparent in the distribution of regenerative therapies. The world's wealthiest nations spend hundreds of millions of dollars on elaborate technologies of life-extension, while contributing much less to efforts to assure basic medical care to the poorest. Public debate on regenerative medicine must acknowledge this inequality. Societies and individuals can invest in it in good conscience only if they are seriously committed to extending extant medicine to all.